Relationship of obstructive sleep apnoea severity and subclinical systemic atherosclerosis

Soriul Kim, Ki Yeol Lee, Nan Hee Kim, Robert D. Abbott, Cherry Kim, Seung Ku Lee, Seong Hwan Kim, Chol Shin

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Obstructive sleep apnoea (OSA) is a common form of sleep disordered breathing. Untreated OSA might accelerate atherosclerosis, potentially increasing the cardiovascular disease burden in patients. The present study aimed to evaluate the association between objectively measured OSA severity and the presence of subclinical systemic atherosclerosis using noninvasive measurements, including tomographic quantification of the calcium burden. A total of 2157 participants of the Korean Genome and Epidemiology Study, who were free of structural heart disease and underwent both in-home polysomnography and chest computed tomography, were cross-sectionally analysed. Participants were divided into three groups based on the severity of OSA: no OSA (apnoea–hypopnoea index (AHI) <5 events•h−1, n=1096), mild OSA (AHI 5–<15 events•h−1, n=700) and moderate-to-severe OSA (AHI ≥15 events•h−1, n=361). Calcium deposits in the thoracic aorta and coronary arteries were measured by the Agatston score. Participants with moderate-to-severe OSA were 1.6 times (95% CI 1.18–2.15 times; p=0.002) more likely to have ascending thoracic aorta calcification (≥100 units) than those without OSA, after adjustment for cardiovascular risk factors. In addition, the association between moderate-to-severe OSA and ascending thoracic aorta calcification of subjects with higher epicardial fat volume was slightly stronger than that in patients without OSA and in the lowest epicardial fat volume tertile (OR 2.11, 95% CI 1.30–3.43). Severity of OSA in the general population was independently associated with subclinical systemic atherosclerosis. These findings highlight the potential importance of severe OSA, especially in subjects with higher epicardial fat, as a possible predictive factor for systemic atherosclerosis and cardiovascular disease.

Original languageEnglish
Article number1900959
JournalEuropean Respiratory Journal
Issue number2
Publication statusPublished - 2020 Feb 1

Bibliographical note

Funding Information:
Support statement: This study was supported by the Korea Centers for Disease Control and Prevention (KCDC) (2013-E71005-00, 2014-E71003-00, 2015-P71001-00 and 2016-E71003-00), the National Research Foundation of Korea (NRF) funded by the Korea government (MSIP) (NRF-2016R1A2B4012155, NRF-2017R1A6A3A11034663 and NRF-Brain Pool Program-2019H1D3A2A01101353), and the Korea University Grant. Funding information for this article has been deposited with the Crossref Funder Registry.

Publisher Copyright:
Copyright © ERS 2020

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


Dive into the research topics of 'Relationship of obstructive sleep apnoea severity and subclinical systemic atherosclerosis'. Together they form a unique fingerprint.

Cite this